What is XDR TB?: Sounds like the latest offer from Microsoft, but XDR TB stands for extensively drug resistant tuberculosis. Tuberculosis, unfortunately, is not a disease of the past. XDR TB is currently threatening people in South Africa and is also present in Russia access to healthcare services is poor. The international humanitarian organization, Doctors Without Borders, known by its acronym in French, MSF, calls XDR TB one of the "Top 10 Undereported Humanitarian Stories of 2006. Multi-drug resistant TB, a precursor of XDR TB, is present in dozens of countries.
Who gets XDR TB? : TB generally is found in people with weak immune systems. XDR TB is coming back with a vengeance right on the heels of HIV/AIDS. XDR TB probably developed because cases of normal TB were not treated properly. TB became multi-drug resistant TB, MDR TB, and now extensively drug resistant tuberculosis has emerged. No one knows exactly how many cases of XDR TB exist since TB surveillance in countries most affected by TB is poor. A safe estimate would be less than 500,000 cases in the world of XDR TB exist, the number of multi-drug resistant tuberculosis cases reported in 2004.
What are the symptoms of XDR TB?: Symptoms of XDR TB are the same as for any kind of tuberculosis, the difference is only that the particular mycobacterium cannot be killed by any drugs we have today. XDR TB can only be determined in laboratories, but results take 6-16 weeks to obtain.
Symptoms and signs of TB are:
- nausea
- weakness
- fatigue,
- rapid weight loss
- fever
- cough
- night sweats
- the coughing up of blood
How deadly is XDR TB?: Normal TB can be treated with what are called first line antibiotics. Multi-drug resistant TB can be treated with two classes of second-line drugs. But XDR-TB cannot be treated effectively with anything. In a press release from a TB symposium the organization held in New York in January 2007, MSF states that while 25 new HIV drugs have come out in the last 25 years, the last novel drug for TB was developed in the 60's. All six classes of second line drugs are used to fight XDR TB and 50-60 per cent of patients infected with the disease are cured.
How can XDR TB be prevented?: The same way ordinary tuberculosis is prevented. Most healthy people do not get tuberculosis unless they are in very close contact with people infected with TB. Tuberculosis is spread through the air on droplets. Healthcare workers and people who are in close contact with TB patients need to wear protective equipment such as masks. People in the first two weeks of tuberculosis treatment should cover their mouth when coughing and dispose of used tissues. The WHO also recommends that healthcare workers should know their HIV status in order to avoid putting themselves at risk.
How can TB be prevented from turning into XDR TB?: If diagnosed with TB, strictly adhere to the treatment regime. It is thought that drug resistant TB has arisen from TB that has been incompletely or improperly treated. People living with HIV/AIDS should be given a TB test, and if TB positive, should start TB treatment before the disease shows its face.
How likely am I to get XDR TB?: XDR TB is still pretty rare and in general healthy people will not develop tuberculosis disease. The WHO does not recommend against travel to any of the countries with tuberculosis of any kind. Healthcare workers, however, should take care to follow proper procedure to protect themselves from TB infection.
Sources:
- WHO. South Africa is moving swifly to combat the threat of XDR-TB. Dec 2006.
- WHO.UN Special Envoy warns of deadly synergy between TB and HIV. Nov 29, 2006.
- WHO. Frequently Asked Questions. XDR TB.